{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:54:17Z","timestamp":1787590457759,"version":"build-2736575974"},"reference-count":27,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>Background: High thoracic epidural analgesia (HTEA) plays a pivotal role in reducing stress and neuroendocrine response in cardiac surgeries. Aim: The primary objective is to assess the effect of HTEA, in pediatric cardiac surgery, on inflammatory markers (interleukin [IL]-6, IL-8, and tumor necrosis factor-\u03b1). The secondary objectives are to assess its effect on various organ systems, that is, pulmonary (PaO2, P\/F ratio), renal (Creatinine clearance, somatic near infrared spectroscopy [NIRS], serum neutrophil gelatinase\u2013associated lipocalin values), cardiac (cardiac index, serum Trop-I, and lactate levels), mechanical ventilation duration, and length of stay in hospital (LOS). Methods: The study included 188 pediatric patients, who underwent, on-pump cardiac surgery randomized into the Epidural Group (n\u2009=\u200992) and Non-Epidural Group (n\u2009=\u200996). After general anesthesia, a 23 G epidural catheter was placed at the T4-5 level with a Bupivacaine infusion while the Non-epidural Group received fentanyl infusion. Blood samples were collected at four-time points, T0(preop), T1(4\u2005h), and on the first and second postoperative days (T2 and T3). Results: The inflammatory markers were reduced, while the outcomes variables of mechanical ventilation (MV) duration had lower values in the epidural group (19.5\u2005h vs 47.3\u2005h, P\u2009=\u2009.002). LOS was shorter (10.1 days vs 13.3 days, P\u2009=\u2009.016). pO2, PF ratio, and renal NIRS values were better in the Epidural Gp, while other parameters were comparable. Non-epidural Gp had more complications esp. Acute kidney injury requires RRT. Conclusion: HTEA use in pediatric, on-pump cardiac surgery offers a favorable profile in terms of reduction in the inflammatory markers and positive effect on the organ systems with lesser MV duration and the LOS.<\/jats:p>","DOI":"10.1177\/21501351221151053","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T01:14:52Z","timestamp":1677201292000},"page":"334-344","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Common Inflammatory Markers and Outcome After Pediatric Cardiac Surgery With High Thoracic Epidural Anesthesia: A Randomized Controlled Study"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2037-2173","authenticated-orcid":false,"given":"Alok","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Anaesthesia & Critical Care, Army Hospital (Research & Referral), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7944-0214","authenticated-orcid":false,"given":"Gurpinder Singh","family":"Ghotra","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia & Critical Care, Army Institute of Cardiothoracic Sciences, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Dwivedi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia & Critical Care, Department of Anaesthesia & Critical Care, Command Hospital (Eastern command), Kolkata, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5574-9188","authenticated-orcid":false,"given":"D. V.","family":"Bhargava","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia & Critical Care, Army Institute of Cardiothoracic Sciences, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankur","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia & Critical Care, Army Hospital (Research & Referral), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Army Hospital (Research & Referral), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1504-778X","authenticated-orcid":false,"given":"H. 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